IF A HURRICANE STRIKES WHERE YOU LIVE, HOW DOES IT AFFECT YOUR HEALTH AND WELL-BEING? In KHN’s next Facebook Live event, senior correspondent Julie Appleby and Georges Benjamin, the executive director of the American Public Health Association, will discuss the continuing public and environmental health issues resulting from Hurricanes Harvey, Irma and Maria. The chat will be held Oct. 11 at 12 p.m. You can send questions about these and other public health topics here and tune in here.

From Kaiser Health News - Latest Stories:

Federal funding for the Children’s Health Insurance Program expired Sept. 30. Many states still have money in their budgets, but they’ll be worried until Congress renews the program. (Phil Galewitz,
10/3)

Hospitals view adding trauma care as a potential profit tool, but experts say having more centers does not necessarily improve the system’s ability to respond to a mass casualty event. (Julie Appleby and Phil Galewitz,
10/4)

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Summaries Of The News:

“It’s very hard for a regulator to deny those rate increases when we can take a look at their bottom line and can tell they can’t continue if they can’t keep their head above water,” said Mike Kreidler, Washington State’s insurance commissioner and a supporter of the health law. Meanwhile, lawmakers are moving forward with bipartisan talks to try to stabilize the marketplace.

The New York Times:
With Affordable Care Act’s Future Cloudy, Costs For Many Seem Sure To Soar
Health insurers are aggressively increasing prices next year for individual policies sold under the federal health care law, with some raising premiums by more than 50 percent. By approving such steep increases for 2018 in recent weeks, regulators in many states appeared to be coaxing companies to hang in there, despite turmoil in the market and continuing uncertainty in Congress about the future of the law, the Affordable Care Act. (Abelson, 10/3)

The Hill:
GOP Gives Ground In ObamaCare Stabilization Talks
Republicans are willing to provide insurers with two years of ObamaCare subsidies under a bipartisan market stabilization bill, according to the Senate Health Committee chairman. Sen. Lamar Alexander (R-Tenn.) said continuing cost-sharing reduction subsidies for two years is a key part of the stabilization package he is trying to negotiate with Sen. Patty Murray (D-Wash.). (Weixel, 10/3)

The Hill:
Health Industry Pressures Congress To Stabilize Individual Market
The Council for Affordable Health Coverage (CAHC) is urging Congress to take several bipartisan steps to help stabilize the individual insurance markets. In a letter to Democratic and Republican leaders in both chambers, the coalition of drugmakers, insurers and others in the health sector is seeking a federal reinsurance program or a grant program to provide money for state-led reinsurance programs. (Roubein, 10/3)

And in other news —

The Hill:
Ex-Obama Officials Launch Group To Sign People Up For ObamaCare
Former Obama administration officials are launching an effort to sign people up for ObamaCare, saying they need to fill the gap left by the Trump administration’s cutbacks. Lori Lodes and Joshua Peck, who oversaw enrollment efforts in the Department of Health and Human Services under President Barack Obama, are launching the group called Get America Covered. (Sullivan, 10/4)

Politico Pro:
CMS Official Boasts Of Filling Obamacare 'Bare Counties'
A top CMS official on Tuesday told staff that the agency is “really proud” that there are no counties lacking an Obamacare insurer, saying it was the Trump administration’s goal to make sure every area had at least one company offering plans in the law's exchanges. The comments came from Randy Pate, who was appointed by the administration to helm the office at CMS that oversees Obamacare implementation, on Tuesday afternoon during a meeting of agency staff in which top officials discussed agency priorities, according to a video obtained by POLITICO. (Pradhan, 10/3)

The Star Tribune:
Gov. Dayton Makes Second Plea For MinnesotaCare
Gov. Mark Dayton renewed efforts Tuesday to reverse a decision by federal health officials that could cost the state $369 million a year in connection with its MinnesotaCare health insurance program. In a letter to top health regulators in Washington, D.C., Dayton urged them to reconsider a recent decision that would sharply cut the federal funding stream that helps pay for MinnesotaCare. (Howatt, 10/3)

Despite the push by Sen. Bill Cassidy (R-La.) to revive the stalled Republican Graham-Cassidy legislation, Senate leaders and committees have not given any hints that they expect the measure to come up again soon.

Roll Call:
Cassidy Eyes Changes To Health Care Bill While Trying To Win Support
Louisiana Sen. Bill Cassidy said there will be changes to a proposal he wrote to overhaul the 2010 health law as he and fellow Republican Sen. Lindsey Graham of South Carolina try to win more support for the measure while other lawmakers focus on tax legislation. ... Cassidy said he and other sponsors need to promote the plan in the coming months so people can learn about the changes the bill would make and better understand it. He said that time could also be used to address concerns of lawmakers such as Arizona GOP Sen. John McCain, who had concerns with the abbreviated process. Neither the Senate Finance Committee nor the Health Education, Labor and Pensions Committee has indicated they have plans to hold more hearings on the bill. (McIntire, 10/3)

Roll Call:
CBO Still Expected To Analyze Graham-Cassidy Health Care Measure
The Congressional Budget Office will still release a full analysis of a proposal from four Republican senators that would overhaul the health care system, according to one of the bill’s main sponsors. During an interview for Tuesday’s CQ Roll Call Big Story Podcast, Sen. Bill Cassidy of Louisiana said a full score from the nonpartisan budget office is still expected. He believes that report could help dispel some of the opposition to the legislation. (Williams, 10/2)

Democrats oppose Republicans' efforts to scrap the Affordble Care Act’s prevention fund, which has been criticized as a "slush fund," and don't like the GOP's proposal to remove lottery winners from state Medicaid programs. Meanwhile, states are bracing for the impact if the money is not renewed.

Politico Pro:
House GOP Proposal To Pay For CHIP Program Likely To Rankle Democrats
House Republicans’ package to extend funding for the Children’s Health Insurance Program and other public health programs would use Obamacare’s prevention fund and entitlement programs to pay for it — moves that could threaten bipartisan backing for the bill. Republicans as part of their five-year CHIP funding extension want to increase means-testing in Medicare for wealthier seniors, allow states to remove lottery winners from state Medicaid programs and change Medicaid’s third-party liability policy that dictates who pays claims for enrollees before Medicaid must be responsible for costs. (Pradhan, 10/3)

The New York Times:
States Gird For Worst As Congress Wrestles With Children’s Insurance Program
Federal officials on Monday approved a $3.6 million emergency infusion for Minnesota after the state’s human services chief warned that pregnant women and some children were at imminent risk of losing health care coverage under the Children’s Health Insurance Program. Utah, meantime, has formally requested authority to “eliminate eligibility and services under CHIP” if the state does not have enough money to continue coverage. (Pear, 10/3)

Modern Healthcare:
States Search For Stopgaps As Congress Misses CHIP Deadline
Now that the federal funding deadline for the Children's Health Insurance Program has lapsed, Minnesota officials have found themselves in an uncomfortable waiting game.
The state had expected to run out of money for CHIP in the coming days, but the CMS said it would provide a last-minute reprieve. The federal agency told Minnesota officials that it plans to reallocate some unspent CHIP funds from around the country to states that were expected to exhaust their funds first, according to Emily Piper, commissioner of Minnesota's Department of Human Services. (Dickson, 10/3)

Kaiser Health News:
5 Takeaways From Congress’ Failure To Extend Funding For Children’s Coverage
Congress finally seems ready to take action on the Children’s Health Insurance Program after funding lapsed Sept. 30. Before the deadline, lawmakers were busy grappling with the failed repeal of the Affordable Care Act.CHIP covers 9 million children nationwide. But until Congress renews CHIP, states are cut off from additional federal funding that helps lower- and middle-income families. (Galewitz, 10/3)

The House Energy and Commerce Committee tucked the request into the bill to reauthorize the Children's Health Insurance Program.

Reuters:
House Republicans Seek $1 Billion In Medicaid Funds For Puerto Rico
Puerto Rico, struggling to recover from hurricane damage, could receive $1 billion in additional funding for the Medicaid health insurance program for the poor under a proposal from a U.S. House of Representatives panel, a congressional aide said on Tuesday. Republicans who lead the House Energy and Commerce Committee included the request for more Medicaid funding for Puerto Rico as part of a separate bill to reauthorize the Children's Health Insurance Program. It is scheduled to be considered and voted on in committee on Wednesday. (Cornwell, 10/3)

The Hill:
GOP Bill Would Direct Extra Medicaid Funds To Puerto Rico
The legislation is the first Republican request to direct extra Medicaid money to Puerto Rico in the wake of Hurricane Maria. The island is still trying to deal with the severe damage it received from the storm. The legislation from the House Energy and Commerce Committee mirrors a bipartisan proposal in the Senate Finance Committee, but it also includes some potentially controversial offsets. (Weixel, 10/3)

A study finds states that didn't expanded their Medicaid programs under the federal health law saw the percentage of people with unpaid medical bills fall only about half as much as in states that expanded. Also, a plan to reform Michigan's auto insurance could backfire on the Medicaid program, and questions are raised about Kentucky officials' attempts to keep documents private dealing with their efforts to revamp the state's Medicaid program.

KCUR:
In States Like Missouri And Kansas That Didn’t Expand Medicaid, Residents Carry Higher Medical Debt
In 2015, 30.6 percent of Missouri adults ages 18 to 64 had past due medical debt, the seventh-highest rate in the country. Kansas, at 27 percent, had the 15th highest rate. Researchers Aaron Sojourner and Ezra Golbertstein of the University of Minnesota studied financial data from 2012 to 2015 for people who would be eligible for Medicaid where it was expanded. They found that in states that didn’t expand, the percentage of low-income, nonelderly adults with unpaid medical bills dropped from 47 to 40 percent within three years. ... But in expansion states? “Where they did expand Medicaid, it fell by almost twice as much,” Sojourner says. (Smith, 10/4)

The Detroit News:
Auto Reform Plan: $150M More In Medicaid Costs
A new bipartisan auto insurance reform plan backed by Detroit Mayor Mike Duggan and House Speaker Tom Leonard would reduce motorist premiums but shift significant health care costs onto Medicaid, according to a new analysis. The non-partisan House Fiscal Agency projects the plan would increase costs for the government health insurance program by $10 million in the first year of implementation and $150 million a year within a decade. (Oosting, 10/3)

Scott Gottlieb has won over many criticis by seeking to widen access to generic drugs, asserting that the agency should play a role in addressing the nation’s opioid epidemic, and announcing plans to tighten regulations on tobacco products. In other news, House Speaker Paul Ryan (R-Wis.) reportedly asked the White House to reconsider Tom Price's departure before the resignation of the secretary of Health and Human Services was announced.

Stat:
Scott Gottlieb Rocketed To The Top Of FDA. He May Keep Rising
When President Trump nominated Scott Gottlieb as the head of the Food and Drug Administration, he was quickly pegged by many as a conservative businessman who was cozy with the pharmaceutical industry. Seven months later, he is attracting praise from some of President Trump’s staunchest critics — including former Obama administration officials. He may also be in line to succeed his old boss, Tom Price, as secretary of health and human services. (Swetlitz, 10/4)

Politico:
Ryan Asked White House To Reconsider Ousting Price
Speaker Paul Ryan last week urged the White House to reconsider ousting Health and Human Services Secretary Tom Price, his longtime friend who had come under fire for often using taxpayer-funded private jets for travel, according to two people with knowledge of the call. John Kelly, the White House chief of staff, called the Wisconsin Republican minutes before the departure was announced Friday afternoon. It was a heads-up call, one White House official said. (Dawsey and Bade, 10/3)

The Hill:
Top Dem Demands Answers: Did Price Pay Back For Private Travel?
A top Democratic senator is demanding to know if former Health and Human Services (HHS) Secretary Tom Price has reimbursed taxpayers for his use of charter flights on official government business. In a letter obtained by The Hill, Sen. Patty Murray (D-Wash.) on Tuesday asked Treasury Secretary Steven Mnuchin to confirm whether Price has in fact sent a check to the U.S. Treasury, and for how much. (Weixel, 10/3)

The House Energy and Commerce Committee on Tuesday heard from Food and Drug Administration Commissioner Scott Gottlieb, who shared his concerns about the scope of the Senate's measure.

Stat:
House Lawmakers Unsure Of Senate Right-To-Try Bill, As Gottlieb Suggests Narrower Scope
Supporters of a Senate-passed “right-to-try” bill that aims to help terminally ill patients gain access to experimental treatments are pushing for the House to act quickly on the measure — but key House leaders showed little interest in that push. Sen. Ron Johnson (R-Wis.), who threatened to hold up a bipartisan and timely package of Food and Drug Administration policies in August in order to push his right-to-try legislation through the Senate, called on the House this week to pass his bill without changing a word. Any modifications in the House would force the Senate to reconsider the bill anew. (Mershon, 10/3)

In other news —

Bloomberg:
FDA Hints It May Look Into Marijuana Health Claims
The U.S. Food and Drug Administration may start cracking down on claims that marijuana has health benefits that haven’t been proven, the agency’s commissioner said Tuesday. “I see people who are developing products who are making claims that marijuana has antitumor effects in the setting of cancer,” FDA Commissioner Scott Gottlieb said at a hearing before Congress on a separate matter. “It’s a much broader question about where our responsibility is to step into this.” (Cortez, 10/3)

California Healthline:
Your Grandma’s Guide To Grass: State Rolls Out Website To Cut Through Cannabis Haze
Every day, Anna Denny encounters people who know their way around a joint. Denny owns Elevated 916, a smoke shop in north Sacramento that sells tobacco products and smoking accessories. But many of her customers don’t limit their smoking to tobacco. Because they’ve been there, done that, Denny just can’t imagine them using a new state website that offers resources — and plenty of warnings — about the use of marijuana now that lighting up recreationally is legal in California. (Ibarra, 10/3)

Sen. Robert Menendez (D-N.J.) is accused of misusing his office to do favors for a wealthy Florida eye doctor and political donor, in exchange for hundreds of thousands of dollars in campaign contributions. Prosecutors say Menendez took bribes to help the doctor with a Medicare dispute.

The Associated Press:
Meeting With Former Health Chief Is Focus Of Menendez Trial
The former head of the trillion-dollar federal agency that oversaw the implementation of the Affordable Care Act testified Tuesday she found it unusual when she was asked to meet in 2012 with U.S. Sen. Bob Menendez at the request U.S. Sen. Harry Reid to discuss what she took to be an issue surrounding one physician’s Medicare billing dispute. Five years later, that meeting is playing a central role in the bribery case against Menendez, a New Jersey Democrat, and the physician, Salomon Melgen, who is charged with plying Menendez with free trips on his private plane and other gifts in exchange for Menendez’s political influence on the Medicare dispute and other matters. (Porter, 10/3)

The Washington Post:
Former HHS Secretary Testifies In Menendez Corruption Case That She Declined To Help New Jersey Senator
[Kathleen] Sebelius, testifying as a prosecution witness in Menendez and Melgen’s federal corruption trial, recounted the events leading up to an August 2012 meeting with Menendez and then-Senate Majority Leader Harry Reid (D-Nev.) at Reid’s office. “I don’t know exactly what [Menendez] wanted, just that he wanted me to do something,” Sebelius, a Kansas Democrat who led HHS from 2009 to 2014, testified. “My definite impression was that he was very concerned that the policy was inconsistent and unfair and something should be done.” (Maimon, 10/3)

The New York Times:
At Menendez Trial, Ex-Health Secretary Recalls An ‘Unusual’ Meeting
“It was unusual for Senator Reid to ask me to come to a meeting involving another member of Congress,” she said. “I think this was the only time in five and a half years that that occurred." ”What also made the meeting different, Ms. Sebelius added, was the topic. “I was asked to discuss a practice involving a billing issue before Medicare and Medicaid services,’’ she said. “That was not something that I was personally involved in on a basis like this.” (Corasaniti, 10/3)

Bloomberg:
Senator Menendez Arranged Rare Meeting With Cabinet Secretary Sebelius, Jury Told
Senator Robert Menendez took the rare step of arranging a meeting with an Obama cabinet secretary to criticize a Medicare policy at the heart of a billing dispute between his close friend and the U.S. government, jurors at the lawmaker’s bribery trial were told. Kathleen Sebelius, the former Secretary of Heath and Human Services, testified Tuesday that the meeting with Menendez was the only time in her five years of running the department when a billing dispute reached her level. (Weinberg and Voreacos, 10/3)

The House Energy and Commerce panel added the delay of disproportionate-share hospital funding cuts to the CHIP reauthorization bill. Hospitals in New Jersey, Texas and Massachusetts also make headlines today.

Modern Healthcare:
House Panel Proposes Delay In Cuts To Uncompensated-Care Funding
House lawmakers have made a move to postpone a multibillion-dollar cut to federal funds to offset hospitals' uncompensated-care costs. The House Energy and Commerce Committee added language that would delay the disproportionate-share hospital funding cuts to its Children's Health Insurance Program reauthorization bill. The Affordable Care Act required the CMS to cut Medicaid DSH funds by $43 billion between fiscal 2018 and 2025. The cuts build year over year, starting at $2 billion in fiscal 2018 and ending at $8 billion in fiscal 2025. (Dickson, 10/3)

The Philadelphia Inquirer/Philly.com:
South Jersey Hospital Is On Life Support, Lawmakers Say, Seeing Rescue In Disputed Trust Fund
The Memorial Hospital of Salem County, which has been struggling for years, remains on life support and desperately needs an infusion of cash from a trust fund to keep its doors open, state lawmakers said Tuesday. A trio of lawmakers led by State Senate President Steve Sweeney (D., Gloucester) called for the return of the $51 million trust fund to Salem County to help facilitate the sale of the hospital. The money was set aside for the Salem Health and Wellness Foundation when the hospital was sold earlier, in 2002. (Burney, 10/3)

Boston Globe:
Lahey Health Is Laying Off About 75 Employees
Lahey Health System on Tuesday became the latest local hospital system to slash expenses by cutting jobs. ... The cuts come as Lahey is pursuing a big merger with Beth Israel Deaconess Medical Center and several other hospitals. (Dayal McCluskey, 10/3)

With overwhelming Democratic opposition in the upper chamber, it would be nearly impossible for the legislation to get the 60 votes. In other news: in many parts of the country abortion clinics are few and far between; Planned Parenthood and the ACLU are both suing over restrictions on abortion pills; a ruling will allow Planned Parenthood to seek more abortion licenses in Missouri; and more.

The Associated Press:
House Approves GOP Bill Outlawing Most Late-Term Abortions
Most late-term abortions would be outlawed under legislation Republicans pushed through the House on Tuesday, a major priority of the GOP and conservative groups that won't reach an eager President Donald Trump because it faces certain Senate defeat. The House approved the measure by a near party-line 237-189 vote. Though the bill's fate is sealed, the push for abortion restrictions remains a touchstone issue for most Republicans, even as the party splinters between traditionalist conservatives and anti-establishment voters looking to roil Washington. (10/3)

The Washington Post:
With Trump’s Backing, House Approves Ban On Abortion After 20 Weeks Of Pregnancy
The bill, known as the Pain-Capable Unborn Child Protection Act, is not expected to emerge from the Senate, where most Democrats and a handful of moderate Republicans can block its consideration. But antiabortion activists are calling President Trump’s endorsement of the bill a significant advance for their movement. The White House said in a statement released Monday that the administration “strongly supports” the legislation “and applauds the House of Representatives for continuing its efforts to secure critical pro-life protections.” (DeBonis and Johnson, 10/3)

Stat:
House Passes 20-Week Abortion Ban, As GOP Proponents Cite 'Fetal Pain'
The co-chairs of the House Pro-Choice Caucus, Reps. Diana DeGette (D-Colo.) and Louise Slaughter (D-N.Y.), along with Rep. Barbara Lee (D-Calif.), said in a statement the ban “endangers women, interferes with their private health care decisions, and marginalizes sexual assault victims while also being blatantly unconstitutional.” Ninety-nine percent of abortions already take place before 21 weeks, according to Planned Parenthood. (Facher, 10/3)

The Hill:
House Passes 20-Week Abortion Ban
The bill, sponsored by Rep. Trent Franks (R-Ariz.), would make it a crime to perform or attempt an abortion after 20 weeks of pregnancy, with the possibility of a fine, up to five years in prison or both. (Hellmann, 10/3)

NPR:
For Many Women The Nearest Abortion Provider Is Many Miles Away
There's a clinic that's right in Kelsey's town of Sioux Falls, S.D., that performs abortions, but she still drove hours away to get one. Back in 2015, she was going through a difficult time — recently laid off, had to move suddenly, helping a close family member through some personal struggles — when she found out she was also pregnant. (McCammon, 10/3)

The Associated Press:
Planned Parenthood Seeks Halt To Arkansas Abortion Pill Law
Planned Parenthood asked a federal appeals court Tuesday to prevent Arkansas from enforcing restrictions on how the abortion pill is administered while the organization asks the nation's highest court to review a ruling in favor of the new limits. Planned Parenthood Great Plains asked the 8th U.S. Circuit Court of Appeals to not allow its ruling in favor of the restrictions to take effect yet. (10/3)

The Associated Press:
ACLU Sues To Challenge FDA Limits On Access To Abortion Pill
The American Civil Liberties Union sued Tuesday in a challenge to federal restrictions that limit many women's access to the so-called abortion pill. The lawsuit, filed in U.S. District Court in Hawaii, targets long-standing restrictions imposed by the Food and Drug Administration that say the pill, marketed in the U.S. as Mifeprex, can be dispensed only in clinics, hospitals and doctors' offices. The lawsuit contends the drug — used for abortions up to 10 weeks of pregnancy — should be made available by prescription in pharmacies across the U.S. (10/3)

The Associated Press:
Court Ruling Favors Planned Parenthood In Missouri
A federal appeals court ruling has opened the door for Planned Parenthood to pursue abortion licenses in more areas of Missouri. The 8th U.S. Circuit Court of Appeals on Monday lifted a temporary stay that had allowed the state to continue enforcing certain abortion requirements while appealing a lower court's ruling that the requirements infringed on women's abortion rights. The appeals court didn't explain its decision. (10/3)

KCUR:
On Same Day Court Blocks Missouri Abortion Restrictions, State Says It Will Impose Another
The same day a federal appeals court overruled itself and voted to block two Missouri abortion restrictions, the state advised Missouri abortion providers that they will have to abide by a new restriction. A memo dated Oct. 2 from the Missouri Department of Health and Human Services (DHSS) says the agency will file emergency rules on Oct. 24 establishing standards for “complication plans” for medication-induced abortions. (Margolies, 10/3)

The New York Times:
Anti-Abortion Congressman Asked Woman To Have One, Report Says
Representative Tim Murphy of Pennsylvania, a strong and frequent critic of abortion, asked a woman with whom he was having an affair to undergo an abortion, according to a report published on Tuesday by The Pittsburgh Post-Gazette. Mr. Murphy, 65, who is married with an adult daughter, confirmed last month that he “became involved in an affair with a personal friend,” according to a statement previously provided to The Post-Gazette. (Stevens, 10/3)

“You’re standing in a pool of blood trying to care for your patient, slipping and sliding,” said trauma nurse Renae Huening. Meanwhile, officials are seeking certified trauma counselors to help serve the mental health needs of those who were affected by the shooting.

The Washington Post:
As The Wounded Kept Coming, Hospitals Dealt With Injuries Rarely Seen In The U.S.
As trauma nurse Renae Huening rushed into Sunrise Hospital and Medical Center on Sunday night, she “followed a trail of blood indoors. ”Dozens of patients already were crammed into the waiting area, hallways and rooms of the hospital’s emergency department. Some were “red-tagged,” meaning they needed attention immediately. Names were being assigned randomly because there was no time to register people or find IDs. Huening could smell the blood. (Craig, Mello and Sun, 10/3)

The Washington Post:
Who Will Take Care Of Nevada’s Wounded Psyche?
The call went out Monday from the Mandalay Bay Resort and Casino. Less than 24 hours earlier, from a suite on the 32nd floor, Stephen Paddock had squeezed off enough rounds from an AK-47-type rifle to kill at least 59 people and injure more than 500. And now, again, the hotel sought urgent help. “We are in need of certified trauma counselors,” it tweeted. And then these details: “If you can volunteer your time, please go to Circus Circus — Ballroom D where you will be given an assignment. . . . We are grateful for the support of our community.” (Nutt, 10/3)

San Francisco Chronicle:
Las Vegas Massacre Reverberates In Gun-Loving Nevada
In the wake of Sunday’s mass slaughter of 59 people here at the hands of a man who perched himself in a hotel suite above a country music concert with a high-powered arsenal — and apparently one that was fully legal — many Nevadans are loath to link the bloodshed to a gun-friendly culture. (Sernoffsky and Fagan, 10/3)

An investigation by Reveal from The Center for Investigative Reporting found that these facilities, which are meant to be an alternative to jail for those addicted to substances, can be nothing more than "slave camps." In other public health news: genetic testing, the immune system, Pompe disease, pets and cancer, vaccinations, dementia and more.

Reveal:
They Thought They Were Going To Rehab. They Ended Up In Chicken Plants
Across the country, judges increasingly are sending defendants to rehab instead of prison or jail. ...But in the rush to spare people from prison, some judges are steering defendants into rehabs that are little more than lucrative work camps for private industry, an investigation by Reveal from The Center for Investigative Reporting has found. (Harris and Walter, 10/4)

The New York Times:
Personal Genetic Testing Is Here. Do We Need It?
For years, Jody Christ, 62, struggled to control her high cholesterol. Her doctors encouraged her to exercise, change her diet and lose weight, but none of that ever seemed to lower her numbers. When her health plan, the Geisinger Health System of Pennsylvania, offered a genetic test that screens for dozens of hereditary diseases, she submitted a saliva sample and awaited the results. (O'Connor, 10/3)

NPR:
Human Brain Has A Direct Link To The Immune System After All
Fresh evidence that the body's immune system interacts directly with the brain could lead to a new understanding of diseases from multiple sclerosis to Alzheimer's. A study of human and monkey brains found lymphatic vessels — a key part of the body's immune system — in a membrane that surrounds the brain and nervous system, a team reported Tuesday in the online journal eLife. (Hamilton, 10/3)

Stat:
Amicus's New Drug For Pompe Disease Shows Strong Results
When two of John Crowley’s children were diagnosed with the rare and debilitating Pompe disease, he founded a company that helped develop a successful treatment. Now, he’s running another biotech — and clinical trial data presented Wednesday suggest that it’s on the way to developing a more effective drug for the same disease. The new drug from Amicus Therapeutics (FOLD) appears to deliver greater improvements in muscle and lung function for people with Pompe, according to interim data from a small, mid-stage study. (Feuerstein, 10/4)

Stat:
How Pets Could Help Researchers Find The Next Cancer Therapy For Humans
This field of comparative medicine — using animals to better understand and treat human disease — is not new; creatures such as mice, rats, and actual guinea pigs have long been the mainstay of medical research and studies of experimental drugs. What’s different is that veterinarians are now conducting rigorous clinical trials of new treatments with the hope they might eventually benefit humans as well as the family pet. Increasingly, they’re using dogs and cats and other companion animals in these experiments, as medical researchers recognize the limitations of traditional lab animals. (McFarling, 10/4)

The Washington Post:
Failure To Vaccinate Is Likely Driver Of U.S. Measles Outbreaks, Report Says
People who don’t get vaccinated are the most likely reason for the steady increase in the rate of measles and major outbreaks in the United States, according to an analysis released Tuesday. The findings, published in JAMA, add to the body of evidence linking failure to vaccinate with the spread of the highly infectious and potentially fatal disease. Once common in the United States, measles was eliminated nationally in 2000 but has made a return in recent years largely because of people who reject vaccinating their children, experts say. (Sun, 10/3)

The Washington Post:
This Ancient Primate May Be Responsible For Genital Herpes
Our ancestors have been catching herpes since before we were human. The infection is quite common today; the World Health Organization estimates that two-thirds of adults under 50 are infected with the herpes virus that causes oral cold sores. One in six have genital herpes. Yet humans might have dodged herpes' below-the-belt blow if it weren't for an ancient encounter between early members of our genus and a more distant primate relative. (Guarino, 10/2)

The Philadelphia Inquirer/Philly.com:
Why Are Straight Black Women In Philly At High Risk Of HIV? Map Offers Clues
Here’s a lingering public health mystery: Heterosexual black women in Philadelphia are at higher risk of contracting HIV than their white counterparts. But no one can yet say exactly why — or how to fix the problem. It’s probably not behavior: Studies indicate that African American women have fewer sexual partners and are more likely to use condoms than white women from similar economic backgrounds. And they are not members of the highest-risk demographic: gay and bisexual men. (Sapatkin, 10/3)

According to the American Cancer Society, death rates associated with this cancer decreased nearly 40 percent between 1989 and 2015, due in part to technological and treatment advances.

The Washington Post:
Breast-Cancer Death Rate Drops Almost 40 Percent, Saving 322,000 Lives, Study Says
Breast cancer death rates declined almost 40 percent between 1989 and 2015, averting 322,600 deaths, the American Cancer Society reported Tuesday. Breast cancer death rates increased by 0.4 percent per year from 1975 to 1989, according to the study. After that, mortality rates decreased rapidly, for a 39 percent drop overall through 2015. The report, the latest to document a long-term reduction in breast-cancer mortality, attributed the declines to both improvements in treatments and to early detection by mammography. (McGinley, 10/3)

Houston Chronicle:
Technology, Treatment Boost Survival Rates
Survival rates among breast cancer patients have increased, in part due to improvements in breast cancer screenings, treatment and new technologies. "People are living longer with breast cancer," said Dr. Uzma Iqbal, medical director and medical oncologist at the Cypress Fairbanks Medical Center's Cancer Center. At northwest Houston hospitals, 3D mammograms are now regular practice, providing a more accurate x-ray detection tool. Many private insurance providers are now paying for 3D mammograms, which are proven to be significantly more effective. (Santana, 10/3)

Stat:
4 Ways The Trump Tax Changes Could Help The Pharmaceutical Industry
After years of grousing about the tax code, drug makers stand to benefit substantially from the changes the Trump administration is seeking. In fact, to a great extent, the plan that the White House is proposing appears to check off a few key items on an industry wish list, according to one tax expert. ... For one, the corporate tax rate would drop from 35 percent to 20 percent. This is not the 15 percent that Trump promised previously, but it is still a big difference. To compensate for the uptick, companies would be able to immediately write off capital spending for the next five years. (Silverman, 10/2)

Stat:
This Alzheimer's Patient Stars In A Pharma Ad. He May Soon Be Homeless
Brian Kursonis, who was diagnosed last year with early-onset Alzheimer’s at age 55, is a star of the drug industry’s “Go Boldly” campaign — a sophisticated PR push, costing tens of millions a year, to highlight pharma’s commitment to develop cures for dreaded diseases. ...Kursonis hopes he can find a way to earn a living as an advocate, but if money doesn’t come in soon, he won’t be able to make the December rent on his spartan apartment in a suburb outside Charlotte, N.C. He fears he will soon be homeless, his best option the men’s shelter in downtown Charlotte. Kursonis’s story highlights the complicated, often heartbreaking realities that compound the challenges of living with a disease like Alzheimer’s. (Robbins, 10/3)

Kaiser Health News:
Hepatitis C Drug’s Lower Cost Paves Way For Medicaid, Prisons To Expand Treatment
Valerie Green is still waiting to be cured.The Delaware resident was diagnosed with hepatitis C more than two years ago, but she doesn’t qualify yet for the Medicaid program’s criteria for treatment with a new class of highly effective but pricey drugs. The recent approval of a less expensive drug that generally cures hepatitis C in just eight weeks may make it easier for more insurers and correctional facilities to expand treatment. (Andrews, 10/3)

Stat:
Pfizer Loses Battle To Keep Medicaid Rebate Data Hidden From Texas Lawmakers
Pfizer (PFE) lost a round in the larger fight over pharmaceutical pricing when a federal judge ruled that Texas lawmakers should be able to obtain state Medicaid rebate data about its medicines. The drug maker last year filed a lawsuit against the Texas Health and Human Services Commission for releasing the data to a pair of state lawmakers, who sought the information in order to assess drug costs for the state Medicaid program. But Pfizer argued that releasing the data would violate federal and state laws that protect its confidential information. (Silverman, 10/3)

Stat:
Lawmaker Urges Pharma Trade Group To Review Allergan Patent Deal With Mohawks
The controversial patent deal between Allergan (AGN) and a Native American tribe is now engulfing the pharmaceutical industry trade group. In a pointed letter, U.S. Sen. Claire McCaskill (D-Mo.) told the Pharmaceutical Research & Manufacturers of America that it should review whether Allergan’s sales of lucrative patents is in keeping with the organization’s boastful mission to “promote innovation and discourage predatory pricing practices and anticompetitive conduct.” (Silverman, 10/3)

Fox Business:
Prescription Drug Price Gouging: What Seniors Need To Know
Americans spent $457 billion on prescription drugs in 2015, according to a recent issue of the AARP Bulletin. The most popular brand-name drugs rose 208 percent between 2008 and 2016—bad news for retirees living on a fixed income, and according to one senior citizens lobbying group, because Medicare doesn’t have the authority to negotiate drug prices, millions of older Americans are at risk of price gouging for their prescription drugs. (Dowd, 10/1)

Kaiser Health News:
Do Pharma’s Claims On Drug Prices Pass The Smell Test? We Found 5 Stinkers.
Drug companies launched an ad and publicity extravaganza this year right after President-elect Donald Trump said they “are getting away with murder” on sky-high pill prices. More than it has in years, the pharmaceutical industry fears major legislation that would curb prices and shrink profits. TV spots lauding drug companies, quoting poet Dylan Thomas and showing heroic scientists have been hard to escape. (Hancock, 10/2)

Columbus Dispatch:
Kucinich Jumps Into Fight Against Drug Makers
Taxpayers are bailing out drug makers the same way they did big banks back in 2008 and 2009, former U.S. Rep. and presidential candidate Dennis Kucinich said Monday. Kucinich, a Democrat, was in Columbus to announce that he was joining the campaign in support of Issue 2 to end those alleged subsidies, which he said cost the Ohio taxpayer more than $400 million a year. (Schladen, 10/2)

Dayton Daily News:
Ohio Issue 2: Opinions On Both Sides
The Ohio Drug Price Relief Act — Issue 2 on the November ballot — has caused plenty of debate. It would require that the state, including the Ohio Department of Medicaid, pay the same or lower prices for prescription drugs as the U.S. Department of Veterans Affairs — which currently negotiates drug prices at least 24 percent less than other agencies.Here are views from both sides of the issue. (Wedell, 10/3)

Bloomberg:
An Easy Way To Cut Drug Costs
In the absence of national action to control the high price of prescription drugs, California is considering a small state rule that could make a big difference. It targets a game that pharmaceutical companies play to keep people spending more than they need to on medicines. The rule, contained in legislation now on the governor's desk, would bar the use of coupons to help consumers cover the cost of co-payments for any brand-name drugs for which there is a generic alternative that works as well. (9/28)

RealClear Health:
Lowering Hepatitis C Treatment Prices
American consumers have been inundated over the past few years by marketing campaigns for a growing range of anti-viral, biologic “cures” for Hepatitis C. The disease affects between 2.7 million and 3.9 million Americans, and between 75 and 85 percent of those who are infected with Hepatitis C are afflicted with the chronic variant. For an estimated 1 to 5 percent of Hepatitis C patients, it is the major cause of death from liver cancer and cirrhosis. (Thomas Hemphill, 10/2)

Motley Fool:
Pfizer Exposes The Sordid Underbelly Of Drug Pricing
Johnson & Johnson's one of the largest drugmakers in the world, and according to a lawsuit Pfizer has filed, it's leveraging its size to negotiate contracts that prevent insurers from paying for cheaper biosimilars to Remicade, its best-selling drug. Pfizer's suit reveals the lengths to which drugmakers are going to keep sales flowing in from drugs even after patents expire, so let's take a closer look to see what's at stake. (Todd Campbell, 10/2)

Forbes:
Big Pharma Doesn't Want Health Outcomes To Sway Pricing -- At Least Not Yet
When Novartis announced that the price of its new personalized gene therapy for cancer, Kymriah, would be $475,000, Wall Street analysts thought that was a relative bargain, but some health payers didn’t agree. Among the naysayers was Steve Miller, the outspoken chief medical officer of pharmacy benefits manager (PBM) Express Scripts. “We need a new payment model,” declared Miller in a blog post last week. He pointed out that $475,000 is much more than the price of the average specialty drug, and with at least 1,500 experimental gene therapies in the pipeline, the potential for the health care system to be overwhelmed by high-priced, one-time cures is great. That’s why, he said, new payment models should include “tracking [patients’] health outcomes over time to ensure payments aren’t being made if the treatment stops being effective.” (Arlene Weintraub, 9/29)

Bloomberg:
AbbVie's Humira Is An Ageless Wonder
There are very few things biotech and pharma investors are inclined to under-value. But the stunning longevity of the world's best-selling drug -- AbbVie Inc.'s Humira -- might be one of them. Amgen Inc. on Thursday agreed to delay the launch of an Humira copycat until late 2018 in Europe and 2023 in the U.S. I've been skeptical of AbbVie's claims that it could keep Humira competition-free in the U.S. and grow the drug's sales through 2020. But now it seems it just might manage it. (Max Nisen, 10/29)

Forbes:
Fair Prices, Fair Play And Profitable Brands
The price of an Epipen injector has risen from around $100 for a two-pack in 2009 to more than $600 in 2016. Epipen is a life-saving emergency injector for people violently allergic to certain foods, such as peanuts: it will keep a person’s throat from closing up during anaphylactic shock. A year ago, as news spread about this enormous hike in prices, Congress summoned Heather Bresch, the CEO of Mylan, Epipen’s manufacturer, to find out why. She told them that, with rebates and insurance coverage, 85% of patients were actually paying less than $100 for the absurdly-priced medication. But that meant the insurance industry was paying the balance of those higher prices for those with coverage. And it would raise premiums accordingly. In other words, we would all be paying for those unreasonable profits. (Peter Georgescu, 9/27)

Bloomberg:
Valeant Digs Into Its Leverage Spiral
Valeant Pharmaceuticals International Inc. has made some not-terrible business moves in the past few months. The troubled pharma firm has divested assets, raising cash to pay down debt. It has avoided big, public scandals over its accounting. It hasn't filed for bankruptcy. (Max Nisen and Lisa Abramowicz, 10/2)

Health Affairs:
California Takes On Drug Pricing: Real Progress Or Illusion?
Californians and others around the country following the California legislature’s multiyear debate on prescription drug pricing may have stood up and taken notice on September 13 when the state Senate followed the Assembly in passing SB-17 to facilitate greater transparency in brand-name and generic drug pricing. While sponsors often make grandiose claims about the potential impact of their legislation, California senator Ed Hernandez may have set a new standard when he declared that the passage of SB-17 was “a monumental achievement for the entire nation” and “one of the most transformative pieces of health legislation in the country.” (Ian Spatz, 10/2)

Opinion writers offer a range of policy thoughts, including their takes on how Tom Price's Obamacare sabotage will continue after his departure; a recommendation the Republicans approach health reform from the angle of controlling costs, and other thoughts.

The Des Moines Register:
Americans And Iowans Paid A High Price With Tom Price
During his short stint as health and human services secretary, Tom Price didn’t spend all his time on chartered airplanes billed to taxpayers. He was also busy making funding cuts to state programs, endangering disabled seniors, ignoring Medicaid waiver requests and sabotaging the Affordable Care Act. His resignation is welcome. So is his personal check to repay the public for his travels. Congress should ensure that money is delivered. And then lawmakers need to get their act together. (10/3)

Los Angeles Times:
Tom Price May Be Gone, But The Trump Administration's Sabotage Of Obamacare Is Moving Ahead At Full Speed
Health and Human Services Secretary Tom Price is gone, ushered out of office last week after being caught causing $1 million in unnecessary taxpayer expense by chartering private planes and taking military aircraft around the country and the world instead of flying commercial, like normal people. This looks like a case in which the right thing has happened for the wrong reason — or at least for an incomplete reason. The grounds for Price’s ouster should have been his atrocious management of the most important program under his jurisdiction, the Affordable Care Act. Instead of acting to make Obamacare work better for all Americans, Price took every step within his power to undermine the law in ways that will cost American families millions of dollars. (Michael Hiltzik, 10/3)

The Wall Street Journal:
The Health Reform That Hasn’t Been Tried
Republicans have now failed twice to repeal and replace ObamaCare. But their whole focus has been wrong. The debate centered, like ObamaCare, on the number of people with health insurance. A more direct path to broadening access would be to reduce the cost of care. This means creating market conditions long proven to bring down prices while improving quality — empowering consumers to seek value, increasing the supply of care, and stimulating competition. (Scott Atlas, 10/3)

Stat:
Medicare Innovation Can Spur The Next Round Of Payment Reform
Since its creation in the Affordable Care Act, the Center for Medicare and Medicaid Innovation has led efforts at CMS to advance alternatives to fee-for-service. ... But most payment reforms are still at relatively early stages, and private-sector innovators cannot make the shift without the government’s commitment to shift from volume- to value-based payments. With so much at stake, the actions of the Department of Health and Human Services are closely watched. The recent revisions in a set of mandatory payment reform pilots caused some to worry about continued HHS commitment to payment reform. (Mark McClellan and Mike Leavitt, 10/3)

The Washington Post:
Congress Just Let The Program That Keeps My Daughter Alive Expire
My wife and are small-business owners. We teach music to small children and their families in our community. It’s work we love and care deeply about. But it makes it hard to get health insurance on our own. That’s why CHIP is so important: Because of the program, which provides health care to children of low- and moderate-income families, we could follow the advice of our doctors and Luna could get the care she needed. Luna could see new specialists and go to follow-up appointments without us risking bankruptcy — just the first few days of testing and evaluation cost up to $40,000. Thanks to CHIP, my wife and I could focus on growing our business and taking care of our family. (David Berzonsky, 10/4)

Des Moines Register:
With Breast Cancer, Privatized Medicaid Adds Insult To Injury
At least at the cellular level, cancer doesn’t discriminate by income. It strikes rich people and poor people and those in between, forcing new reckonings and leaving emotional and physical scars. October is Breast Cancer Awareness Month, but beneath all the pink-themed marketing is a new normal: Insurance coverage can dictate a woman's recovery. ... If your coverage is through Iowa’s Medicaid program for low-income people, you may find yourself unable to get a post-mastectomy breast prosthesis. That is, unless you can shell out up to $1,000 in cash. (Rekha Basu, 10/3)

The Washington Post:
I’m A Doctor. I Want You To Live And Thrive. So I Want Semiautomatic Guns Banned.
There are no simple solutions to drastically reduce America’s gun violence. Much needs to be done on many fronts, ranging from expanded mental health access to addressing the adverse socioeconomic circumstances that engender street crime and day-to-day violence in the first place. Nevertheless, much will be said about gun control in coming days. Many proposals will be offered, and realistically nothing will be accomplished — at least in the short term. As political circumstances change, however, some good may be able to be done. When that happens, insofar as we want to do anything about the types of guns people can buy, we should aim for an across-the-board semiautomatic firearms ban. (Adam Gaffney, 10/4)

Stat:
Doctors Need Help Managing Their 'Perpetual State Of Transition'
At every level of training beyond medical school, there is a strong assumption that these periods of transition are limited to big new beginnings, and that the trainees will rapidly settle in. Orientations tend to focus on the logistics of starting a new job, pivoting from a deluge of information about electronic medical records and human resources packets to ice breakers and password setups. After a few weeks, programs designed to aid in transitions taper off, aside from a few individual review meetings with the program director. Trainees are expected to take flight relatively independently. (Jason J. Han and Neha Vapiwala, 10/3)

The Columbus Dispatch:
Help For Addicts Only A Click Away
Will addicts in the throes of opioid cravings really click through a smartphone app for help? As central Ohio communities remain overwhelmed by the still-skyrocketing numbers of overdose deaths, the idea is well worth pursuing. The Alcohol, Drug and Mental Health Board of Franklin County will make such an addiction-support app available to 200 drug users within the next few weeks, thanks to a $108,000 donation by The Columbus Foundation for a pilot program. (10/4)

Chicago Tribune:
Abortion Funding, Truthfulness And A Question: Can Rauner Recover?
In the months leading to the March 20 Illinois primary, when incumbents will need majority support in their party, Gov. Bruce Rauner finds himself jilted by much of his 2014 base. His Sept. 28 signature on a controversial abortion bill has undercut his support among former loyalists who hoped that in 2018 he would elevate the GOP from its longstanding minority status in Springfield. (10/3)

St. Louis Post-Dispatch:
Education And Testing Can Help Reduce The High STD Rate In St. Louis
St. Louis health care advocates had something to celebrate recently when the city was toppled for the first time in a decade from its reigning position as the nation’s capital of sexually transmitted diseases. But coming in second place to Etowah County, Ala., still means there’s much work to be done locally to impress upon sexually active people that condoms are the best method to prevent the spread of infection. (10/3)